Provider Demographics
NPI:1053705053
Name:BETZ OPHTHALMOLOGY ASSOCIATES
Entity type:Organization
Organization Name:BETZ OPHTHALMOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:H
Authorized Official - Last Name:BETZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-524-4473
Mailing Address - Street 1:3 HOSPITAL DR
Mailing Address - Street 2:SUITE 112
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9362
Mailing Address - Country:US
Mailing Address - Phone:570-524-4473
Mailing Address - Fax:570-524-4464
Practice Address - Street 1:3 HOSPITAL DR
Practice Address - Street 2:SUITE 112
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-9362
Practice Address - Country:US
Practice Address - Phone:570-524-4473
Practice Address - Fax:570-524-4464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-27
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD451367207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1396978144Medicare NSC